Obsessive Compulsive Disorders (OCD)

The phrase “You are so OCD” tends to get thrown around when people talk about individuals who are detailed, meticulous, or wanting to be in control, and is usually said in a jokingly manner.  However, for individuals who struggle with obsessive-compulsive disorder (OCD), it is far from a joke. People with obsessive-compulsive disorder suffer intensely from repeated unwanted thoughts or rituals which they feel are out of their control.  To be diagnosed with OCD the following symptoms must be present:  1. Obsessions and/or compulsions.  2. The obsessions and/or compulsions must be time-consuming (more than one hour a day); or 3. Cause significant distress or impairment in work, social or other important areas of functioning.

  

According to the International OCD Foundation, approximately 1 in 100 adults and 1 in 200 kids and teens have OCD.  OCD symptoms often begin in childhood, adolescence or early adulthood, however It takes an average of 14-17 years from the time OCD first appears, in order for people to receive appropriate treatment.  This can feel like a lifetime for individuals who suffer with OCD.

With OCD, the obsessions are recurring and persistent thoughts, urges, or images that are involuntary and are intrusive and unwanted. The obsessions foster anxiety and distress for the individual.  This anxiety sends a false message to the individual that they are in danger.  Compulsions are repetitive behaviors, rituals, or mental acts that are usually performed in an attempt to reduce the anxiety or distress, or prevent a dreaded event or situation.  Yet it is the performing of the compulsive behaviors that serve to increase the obsessions, instead of eliminate them. Some of the categories of obsessions include aggressive obsessions, contamination obsessions, the need for symmetry or exactness, and somatic obsessions.  Some examples of compulsions include cleaning/washing, checking, counting, and ordering. When an individual suffers from OCD their world can become increasingly small and isolated due to the dread and fear of the obsessions which permeate their lives.

The primary treatment modalities for OCD are Cognitive Behavior Therapy (CBT)/Exposure Response Prevention (ERP), and a medication regimen.  Education about OCD is also an important aspect of OCD treatment because it allows the individual to gain an understanding of what OCD is, and the role the brain plays.  This in turn promotes the individual’s ability to separate the OCD from themselves, and gain greater recognition and insight into the fallacy of the OCD beliefs.  A big part of CBT/ERP is to increase the individual’s capacity to handle anxiety and teach them healthy and effective ways of responding to the obsessions without participating in the compulsive behaviors.  ERP gradually exposes the individual to the thoughts and images that trigger the anxiety and obsessions without conducting the compulsive behaviors.    

While the treatment regimen for OCD is not easy, it has been shown to be the most effective way of treating OCD.  Going to those places that illicit the anxiety and distress from the obsessive thoughts utilizing subjective units of distress (SUDS), and without performing the compulsive act, initially is very hard.  However, over time you will notice a drop in your level of anxiety when you stay exposed and don’t utilize the response, known as habituation.

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